Provider Demographics
NPI:1902503691
Name:OUTREACH GROUP LLC
Entity Type:Organization
Organization Name:OUTREACH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:413-627-7192
Mailing Address - Street 1:5514 LONGLEAF DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-9456
Mailing Address - Country:US
Mailing Address - Phone:413-627-7192
Mailing Address - Fax:866-472-1997
Practice Address - Street 1:5514 LONGLEAF DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-9456
Practice Address - Country:US
Practice Address - Phone:413-627-7192
Practice Address - Fax:866-472-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility